‘New ICTs’, such as smartphones and tablet computers, have revolutionised work and life in the 21st Century. Crucial to this development is the detachment of work from traditional office spaces. ...Today's office work is often supported by Internet connections, and thus can be done from anywhere at any time. Research on detachment of work from the employer's premises actually dates back to the previous century. In the 1970s and 1980s, Jack Nilles and Allan Toffler predicted that work of the future would be relocated into or nearby employees’ homes with the help of technology, called ‘Telework’. Analysing technological advancements—the enabling forces of change in this context—over four decades sheds new light on this term: they have fostered the evolution of Telework in distinct stages or ‘generations’. Today's various location‐independent, technology‐enabled new ways of working are all part of the same revolution in the inter‐relationship between paid work and personal life.
ABSTRACT
The use of gravitational wave standard sirens for cosmological analyses is becoming well known, with particular interest in measuring the Hubble constant, H0, and in shedding light on the ...current tension between early- and late-time measurements. The current tension is over 4σ and standard sirens will be able to provide a completely independent measurement. Dark sirens (binary black hole or neutron star mergers with no electromagnetic counterparts) can be informative if the missing redshift information is provided through the use of galaxy catalogues to identify potential host galaxies of the merger. However, galaxy catalogue incompleteness affects this analysis, and accurate modelling of it is essential for obtaining an unbiased measurement of H0. Previously most methods have assumed uniform completeness within the sky area of a gravitational wave event. This paper presents an updated methodology in which the completeness of the galaxy catalogue is estimated in a directionally dependent matter, by pixelating the sky and computing the completeness of the galaxy catalogue along each line of sight. The H0 inference for a single event is carried out on a pixel-by-pixel basis, and the pixels are combined for the final result. A reanalysis of the events in the first gravitational wave transient catalogue leads to an improvement on the measured value of H0 of approximately 5 per cent compared to the 68.3 per cent highest density interval of the equivalent LIGO and Virgo result, with H0 = $68.8^{+15.9}_{-7.8}$ km s−1 Mpc−1.
Technological developments have enabled a dramatic expansion and also an evolution of telework, broadly defined as using ICTs to perform work from outside of an employer’s premises. This volume ...offers a new conceptual framework explaining the evolution of telework over four decades. It reviews national experiences from Argentina, Brazil, India, Japan, the United States, and ten EU countries regarding the development of telework, its various forms and effects. It also analyses large-scale surveys and company case studies regarding the incidence of telework and its effects on working time, work-life balance, occupational health and well-being, and individual and organizational performance.
Open
Current guidelines for the treatment of ST-segment elevation myocardial infarction recommend a door-to-balloon time of 90 minutes or less for patients undergoing primary percutaneous coronary ...intervention (PCI). Door-to-balloon time has become a performance measure and is the focus of regional and national quality-improvement initiatives. However, it is not known whether national improvements in door-to-balloon times have been accompanied by a decline in mortality.
We analyzed annual trends in door-to-balloon times and in-hospital mortality using data from 96,738 admissions for patients undergoing primary PCI for ST-segment elevation myocardial infarction from July 2005 through June 2009 at 515 hospitals participating in the CathPCI Registry. In a subgroup analysis using a linked Medicare data set, we assessed 30-day mortality.
Median door-to-balloon times declined significantly, from 83 minutes in the 12 months from July 2005 through June 2006 to 67 minutes in the 12 months from July 2008 through June 2009 (P<0.001). Similarly, the percentage of patients for whom the door-to-balloon time was 90 minutes or less increased from 59.7% in the first year to 83.1% in the last year (P<0.001). Despite improvements in door-to-balloon times, there was no significant overall change in unadjusted in-hospital mortality (4.8% in 2005-2006 and 4.7% in 2008-2009, P=0.43 for trend) or in risk-adjusted in-hospital mortality (5.0% in 2005-2006 and 4.7% in 2008-2009, P=0.34), nor was a significant difference observed in unadjusted 30-day mortality (P=0.64).
Although national door-to-balloon times have improved significantly for patients undergoing primary PCI for ST-segment elevation myocardial infarction, in-hospital mortality has remained virtually unchanged. These data suggest that additional strategies are needed to reduce in-hospital mortality in this population. (Funded by the National Cardiovascular Data Registry of the American College of Cardiology Foundation.).
Summary Background Recent reductions in average door-to-balloon (D2B) times have not been associated with decreases in mortality at the population level. We investigated this seemingly paradoxical ...finding by assessing components of this association at the individual and population levels simultaneously. We postulated that the changing population of patients undergoing primary percutaneous coronary intervention (pPCI) contributed to secular trends toward an increasing mortality risk, despite consistently decreased mortality in individual patients with shorter D2B times. Methods This was a retrospective study of ST-elevation myocardial infarction (STEMI) patients who underwent pPCI between Jan 1, 2005, and Dec 31, 2011, in the National Cardiovascular Data Registry (NCDR) CathPCI Registry. We looked for catheterisation laboratory visits associated with STEMI. We excluded patients not undergoing pPCI, transfer patients for pPCI, patients with D2B times less than 15 min or more than 3 h, and patients at hospitals that did not consistently report data across the study period. We assessed in-hospital mortality in the entire cohort and 6-month mortality in elderly patients aged 65 years or older matched to data from the Centers for Medicare and Medicaid Services. We built multilevel models to assess the relation between D2B time and in-hospital and 6-month mortality, including both individual and population-level components of this association after adjusting for patient and procedural factors. Findings 423 hospitals reported data on 150 116 procedures with a 55% increase in the number of patients undergoing pPCI at these facilities over time, as well as many changes in patient and procedural factors. Annual D2B times decreased significantly from a median of 86 min (IQR 65–109) in 2005 to 63 min (IQR 47–80) in 2011 (p<0·0001) with a concurrent rise in risk-adjusted in-hospital mortality (from 4·7% to 5·3%; p=0·06) and risk-adjusted 6-month mortality (from 12·9% to 14·4%; p=0·001). In multilevel models, shorter patient-specific D2B times were consistently associated at the individual level with lower in-hospital mortality (adjusted OR for each 10 min decrease 0·92; 95% CI 0·91–0·93; p<0·0001) and 6-month mortality (adjusted OR for each 10 min decrease, 0·94; 95% CI 0·93–0·95; p<0·0001). By contrast, risk-adjusted in-hospital and 6-month mortality at the population level, independent of patient-specific D2B times, rose in the growing and changing population of patients undergoing pPCI during the study period. Interpretation Shorter patient-specific D2B times were consistently associated with lower mortality over time, whereas secular trends suggest increased mortality risk in the growing and changing pPCI population. The absence of association of annual D2B time and changes in mortality at the population level should not be interpreted as an indication of its individual-level relation in patients with STEMI undergoing primary PCI. Funding National Heart, Lung, and Blood Institute.
Abstract Background Professional guidelines have reduced the recommended minimum number to an average of 50 percutaneous coronary intervention (PCI) procedures performed annually by each operator. ...Operator volume patterns and associated outcomes since this change are unknown. Objectives The authors describe herein PCI operator procedure volumes; characteristics of low-, intermediate-, and high-volume operators; and the relationship between operator volume and clinical outcomes in a large, contemporary, nationwide sample. Methods Using data from the National Cardiovascular Data Registry collected between July 1, 2009, and March 31, 2015, we examined operator annual PCI volume. We divided operators into low- (<50 PCIs per year), intermediate- (50 to 100 PCIs per year), and high- (>100 PCIs per year) volume groups, and determined the adjusted association between annual PCI volume and in-hospital outcomes, including mortality. Results The median annual number of procedures performed per operator was 59; 44% of operators performed <50 PCI procedures per year. Low-volume operators more frequently performed emergency and primary PCI procedures and practiced at hospitals with lower annual PCI volumes. Unadjusted in-hospital mortality was 1.86% for low-volume operators, 1.73% for intermediate-volume operators, and 1.48% for high-volume operators. The adjusted risk of in-hospital mortality was higher for PCI procedures performed by low- and intermediate-volume operators compared with those performed by high-volume operators (adjusted odds ratio: 1.16 for low versus high; adjusted odds ratio: 1.05 for intermediate vs. high volume) as was the risk for new dialysis post PCI. No volume relationship was observed for post-PCI bleeding. Conclusions Many PCI operators in the United States are performing fewer than the recommended number of PCI procedures annually. Although absolute risk differences are small and may be partially explained by unmeasured differences in case mix between operators, there remains an inverse relationship between PCI operator volume and in-hospital mortality that persisted in risk-adjusted analyses.
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